Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia

Zeisler, Harald; Llurba, Elisa; Chantraine, Frédéric; Vatish, Manu; Staff, Anne Cathrine; Sennström, Maria; Olovsson, Matts; Brennecke, Shaun P.; Stepan, Holger; Allegranza, Deirdre; Dilba, Peter; Schoedl, Maria; Hund, Martin; Verlohren, Stefan

doi:10.1056/nejmoa1414838

Cited by 1,276 publications

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“…l the PROGNOSIS study, reported in a company submission to NICE provided by Roche Diagnostics, 61 an unpublished academic manuscript 73 that was subsequently published by Roche Diagnostics (Zeisler et al 51 ), a meeting abstract (Zeisler et al…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Placental growth factor (alone or in combination with soluble fms-like tyrosine kinase 1) as an aid to the assessment of women with suspected pre-eclampsia: systematic review and economic analysis

Frampton

Jones

Rose

et al. 2016

Health Technol Assess

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growth factor (alone or in combination with soluble fms-like tyrosine kinase 1) as an aid to the assessment of women with suspected pre-eclampsia: systematic review and economic analysis. Health Technol Assess 2016;20(87).Health Technology Assessment is indexed and abstracted in Index Medicus/MEDLINE, Excerpta Medica/EMBASE, Science Citation Index Expanded (SciSearch ® ) and Current Contents ® / Clinical Medicine. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/). Health Technology Assessment NICE TAR and DAREditorial contact: nihredit@southampton.ac.ukThe full HTA archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hta. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Technology Assessment journalReports are published in Health Technology Assessment (HTA) if (1) they have resulted from work for the HTA programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors.Reviews in Health Technology Assessment are termed 'systematic' when the account of the search appraisal and synthesis methods (to minimise biases and random errors) would, in theory, permit the replication of the review by others. HTA programmeThe HTA programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care.The journal is indexed in NHS Evidence via its abstracts included in MEDLINE and its Technology Assessment Reports inform National Institute for Health and Care Excellence (NICE) guidance. HTA research is also an important source of evidence for National Screening Committee (NSC) policy decisions.For more information about the HTA programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hta This reportThe research reported in this issue of the journal was commissioned and funded by the HTA programme on behalf of NICE as project number 14/69/05. The protocol was agreed in March 2015. The assessment report began editorial review in September 2015 and was accepted for publication in June 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HTA editors and publisher have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the draft document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The ...

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Placental growth factor (alone or in combination with soluble fms-like tyrosine kinase 1) as an aid to the assessment of women with suspected pre-eclampsia: systematic review and economic analysis

Frampton

Jones

Rose

et al. 2016

Health Technol Assess

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“…Instead, ultrasonography and maternal serum protein markers have been pursued to noninvasively monitor placental function during pregnancy (3,4). It has been shown that the placenta is the major source of circulating cell-free fetal nucleic acids in maternal plasma (5)(6)(7).…”

mentioning

confidence: 99%

Integrative single-cell and cell-free plasma RNA transcriptomics elucidates placental cellular dynamics

Tsang

Vong

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

258

267

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The human placenta is a dynamic and heterogeneous organ critical in the establishment of the fetomaternal interface and the maintenance of gestational well-being. It is also the major source of cell-free fetal nucleic acids in the maternal circulation. Placental dysfunction contributes to significant complications, such as preeclampsia, a potentially lethal hypertensive disorder during pregnancy. Previous studies have identified significant changes in the expression profiles of preeclamptic placentas using whole-tissue analysis. Moreover, studies have shown increased levels of targeted RNA transcripts, overall and placental contributions in maternal cell-free nucleic acids during pregnancy progression and gestational complications, but it remains infeasible to noninvasively delineate placental cellular dynamics and dysfunction at the cellular level using maternal cell-free nucleic acid analysis. In this study, we addressed this issue by first dissecting the cellular heterogeneity of the human placenta and defined individual cell-type-specific gene signatures by analyzing more than 24,000 nonmarker selected cells from full-term and early preeclamptic placentas using large-scale microfluidic single-cell transcriptomic technology. Our dataset identified diverse cellular subtypes in the human placenta and enabled reconstruction of the trophoblast differentiation trajectory. Through integrative analysis with maternal plasma cell-free RNA, we resolved the longitudinal cellular dynamics of hematopoietic and placental cells in pregnancy progression. Furthermore, we were able to noninvasively uncover the cellular dysfunction of extravillous trophoblasts in early preeclamptic placentas. Our work showed the potential of integrating transcriptomic information derived from single cells into the interpretation of cell-free plasma RNA, enabling the noninvasive elucidation of cellular dynamics in complex pathological conditions. single-cell transcriptomics | cell-free RNA | noninvasive prenatal testing | placenta | preeclampsia

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“…Les concentrations de sENG et le ratio sFLT1/PlGF se sont également avérés être augmentés en cas de PE. Les valeurs prédictives positives de ces mesures, seules, avant 20 semaines d'aménorrhée, restent cependant faibles alors que les valeurs prédictives négatives sont excellentes, ce qui permet de discriminer, dans une population à risque, les femmes qui ne développeront pas de PE précoce [40]. Les outils actuels (paramètres cliniques, histoire médicale de la patiente, facteurs angiogéniques) sont utiles pour différencier les femmes présentant des symptômes de PE mais avec un profil angiogénique normal et un risque faible de complications liés à la PE sévère.…”

Section: Les Cellules Endothélialesunclassified

Nouveaux regards sur la prééclampsie

2017

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> La prééclampsie est une maladie majeure, fréquente et potentiellement sévère de la grossesse, caractérisée par une hypertension gravidique et une protéinurie. Dans cette revue, nous rapportons les progrès récents réalisés dans la compréhension de la pathologie et évoquons ses impacts à long terme sur la santé vasculaire maternelle. Nous décrivons ensuite les bases génétiques, épigénétiques et immunologiques de la prééclampsie. Nous détaillons en particulier les liens entre pathologie et stress oxydatif au niveau des cellules placentaires (trophoblastes) et endothéliales. Nous mentionnons les modèles d'étude cellulaires et animaux couramment utilisés pour décrypter les voies physiopathologiques modifiées dans une grossesse prééclamptique par rapport à une grossesse normale. Enfin, nous évoquons les possibilités thérapeutiques existantes et à venir pour améliorer le suivi des grossesses, la santé des patientes et celles des enfants nés de grossesses prééclamptiques. < La prééclampsie (PE), longtemps considérée comme une maladie mystérieuse à l'étiologie inconnue, naguère dénommée toxémie gravidique, se caractérise par une hypertension artérielle et une protéinurie se déclenchant au plus tôt à la mi-gestation [1] (➜). La maladie induit des répercussions cliniques parfois gravissimes, incluant le syndrome HELLP (hemolysis, elevated liver enzymes, low platelet), pouvant se compliquer d'une coagulation intravasculaire disséminée, ou par l'éclampsie, une crise convulsive géné-ralisée décrite dès l'antiquité, avec un premier cas peut-être identifié il y a 28 000 ans [2]. Au cours des 15 dernières années, des progrès considérables ont été réalisés dans la compréhension de l'étiologie de la PE. La pathologie est considérée comporter deux phases : l'une asymptomatique et très précoce, en relation avec une placentation défectueuse ; l'autre caractérisée par l'apparition des symptômes chez la mère.De la dysfonction placentaire à l'attaque du système vasculaire maternel : des conséquences maternelles et foetales parfois dramatiques La première phase de la PE se caractérise par un défaut d'invasion des trophoblastes qui colonisent les tissus utérins maternels, induisant des anomalies histologiques locales. La deuxième phase correspond au syndrome maternel affectant l'endothélium, probablement par la libération, par le placenta, de molécules anti-angiogéniques dans la circulation maternelle comme sFLT1 (soluble fms-like tyrosine kinase-1) et sENG (soluble endoglin) (Figure 1). sFLT1 (ou sVEGFR1), la forme soluble du récepteur du VEGF (vascular endothelial growth factor) générée par épissage alternatif, inhibe la formation des tubes endothéliaux et bloque les effets vasodilatateurs de ses ligands (VEGF et de PlGF). Similairement, la sENG (l'endogline soluble) joue un rôle anti-angiogénique en inhibant la cascade du TGF (transforming growth factor b), cruciale pour l'angiogenèse. La prééclampsieUne obsession angoissée des services de gynéco-obstétrique dans les pays industrialisés Une jeune mère consulte pour une grossesse « ...

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Predictive Value of the sFlt-1:PlGF Ratio in Women with Suspected Preeclampsia

Abstract: An sFlt-1:PlGF ratio of 38 or lower can be used to predict the short-term absence of preeclampsia in women in whom the syndrome is suspected clinically. (Funded by Roche Diagnostics.).

Cited by 1,276 publications

References 39 publications

Placental growth factor (alone or in combination with soluble fms-like tyrosine kinase 1) as an aid to the assessment of women with suspected pre-eclampsia: systematic review and economic analysis

Placental growth factor (alone or in combination with soluble fms-like tyrosine kinase 1) as an aid to the assessment of women with suspected pre-eclampsia: systematic review and economic analysis

Integrative single-cell and cell-free plasma RNA transcriptomics elucidates placental cellular dynamics

Nouveaux regards sur la prééclampsie

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